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Lesley

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Reply with quote  #1 
was found in the bone scan. On my T9 as they suspected. It did not show up on the MRI, but they are going to biopsy it based on what they saw on the bone scan. I guess the onc wants to test the receptors.

I am numb
jadesloge

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Reply with quote  #2 
I am sorry. I can't even imagine hearing about having cancer again. I'll pray for God to give you strength and that your doctors find the most effective way of treating you as possible.

Julie

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MicheleS

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Reply with quote  #3 
oh sweetie.  {{hugs}} But, I have to ask... was the rest of your scan clean?? Because, bone mets are so very treatable.  Really.

You can do this.  You WILL be ok.  more {{hugs}}

Michele

Lesley

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Reply with quote  #4 
well, yes....the other spots that showed up (shoulder and leg) did not show up again. And NOTHING showed up on the MRI, which is so confusing because I thought the MRI would be more sensitive.

I have a nodule in my lung that they are going to "watch", but for some reason my onc was not concerned that much about it.

I am just so heart broken...not only that its back, but that its back so quickly...I didnt even get a chance to breathe...

and my girls (ages 14, 11, 10) well, they know me, they have grown up with me in their lives...but my boys (4 and 9 months) omg, they wont remember me
MicheleS

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Reply with quote  #5 
I understand.  I have the same thoughts about my 4 yr old.  But, BONE METS ARE TREATABLE!!!! They really, really are.  In fact, many people with bone mets end up being NED after treatment. 
With that said, I know that this news is horrible and I would be freaking out too... and crying... and angry.  You have every right to be frightened. But, you can beat this.  As Gina says, there HAS to be someone (many people) who are in the *good* percentages.

What has your MD said?  Maybe Edge can enlighten us on all of the great treatments for bone mets??

{{hugs}}
Michele

lizws

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Reply with quote  #6 
Hi Lesley,

I'm sorry you've received this news.  You be sad, angry and just depressed for a day or two.  THEN you put on your armor and you forge ahead and beat this damned met.  Bone mets are treatable and there are so many ladies that are doing well with them.   Many of the ladies are doing Zometa.  Some are doing Xeloda.  There are many many options.  Don't give up.  You can do this. 

Hugs


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Reply with quote  #7 
Sweet Lesley,
First, the clear MRI is great news!
Second, I have a lung nodule they have been watching since 2002. It always raises a red flag during tests, but they always say it is not cancer related.

And most importantly, bone mets are the one mets that can be made stable and you are returned to NED status.

Zometa is excellent as well as other drugs. If they can, and the spot is in a good location, they can even radiate the spot away.

My first onc used to tell me, "if you are going to get mets, the best place to get it is in your bone because we can succesfully treat it there."

I am sending you HUGE hugs and lots of love,
g


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Calico

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Reply with quote  #8 
Lesley,
hugs to you girl!!!

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delphinus

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Reply with quote  #9 
Lesley, I'm sorry for the diagnosis, and I completely empathize with your feelings about your children. It's completely normal to filter this kind of thing through the eyes of our children. Painful, but inevitable and understandable. My boys were 3 1/2 years and 6 months old when I was first diagnosed, but you know what? My "baby" Julian is turning 5 next week! And take the others' messages to heart, bone mets IS highly treatable. My situation had much worse implications, and I'm still here!

Please trust me, the shock will ease, and you will be able to regroup your energies soon.

thinking of you,
janet



csp

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Reply with quote  #10 
Lesley,
I hate you are going through this and it's not fair you didn't get a minute to breath! sending you prayers and hugs.

I wanted to tell you about my sister in law  She also barely had time to catch her breath after treatment when they found it in her femur.That was 15 + years ago.  SHE IS NED to date!  She  wore out her implant and just had it replaced last year.

You are in my thoughts,
Carrie

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Calico

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Reply with quote  #11 
Lesley,
sending you hugs, strenght and prayers on this Monday for the coming week!!!!

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mrsb

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Reply with quote  #12 
Lesley sending you big hugs, everywhere i read is that this is very  treatable. life isn't very fair to us gals is it.allow yourself all the time you need then put on big boots and fight backShelagh
edge

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Reply with quote  #13 

Lesley:

 

As usual you have, above, already received some exceptional advice and support from the many exceptional members of the No Surrender community.  Below I review as I see it the present state-of-the-art in treating bone metastases from breast cancer, along with a forward look at an emerging option hopefully to  be available later this Fall:

 

 


Optimal Therapy for BC Bone Metastases 

 

 

Core Anti-Bone Metastasis Therapy: Bisphosphonates

The mainstay of bone-targeted treatment of bone metastasis from breast cancer is  via bisphosphonates, and the two that are best-evidenced for bone-specific anti-tumor anti-metastatic activity and benefit are  (1) zoledronic acid (Zometa) in the United States (where pamidronate (Aredia) is a secondary fallback) and (2) clodronate (Bonefos) outside of  the U.S, especially in  the European community. As I have documented on these forums, these agents  exhibit not only anti-osteoporotic benefit, but also antimetastatic and anti-recurrence activity, as well as potentially their own direct  antitumor activity, and as  the preliminary evidence suggests, and I have argue, there may also be an antiangiogenic effect (as that derived also from bevacizumab (Avastin)).

 

Systemic Therapy

Jeffrey Abrams and colleagues at NCI, among others, have found that there  is between 18%–67% response of metastatic bone lesions to single-agent chemotherapy. For example, paclitaxel (Taxol) alone achieved a disease control rate (DCR)  of 77% (2% complete responses (CR), 21% partial responses,  and 54% stable disease (SD)).  And Gabriel Hortobagyi  at MD Anderson  and colleagues have found efficacy against BC bone metastasis  from:

 

  • all three components of the CMF regimen (5-FU, cyclophosphamide  Cytoxan), and methotrexate),
  • as well as with anthracycline therapy, and
  • the vinca alkaloid vincristine. 

 

From this I would also deduce the benefit of:

 

  • the 5-FU prodrugs gemcitabine (Gemzar) and capecitabine (Xeloda), as well as
  • vinorelbine (Navelbine), a vinca alkaloid, and
  • the anthracyclines epirubicin (Ellence) and Doxil.

 

Furthermore, if the tumors  are endocrine-responsive (hormonal, that is,  with ER+ and/or PR+) then endocrine therapy (aromatase inhibitors (AIs), tamoxifen,  and fulvestrant (Faslodex) may also be of value, as may trastuzumab (Herceptin)  and lapatinib (Tykerb) in  HER2+ tumors.

 

E2100 / E2100+

In addition, although I  am unaware of this being acknowledged directly by oncologists, given the provisional evidence of a potential antiangiogeneic effect, coupled with the Abrams findings cited above, it would strike  me that the Kathy Miller E2100 regimen (paclitaxel (Taxol)  + bevacizumab (Avastin)) or what I  call the E2100+ regimen (nab-paclitaxel (Abraxane) + bevacizumab (Avastin)) may be more highly evaluated than taxane monotherapy (which  itself achieves a  77% disease control rate).   

 

Denosumab (Prolia)

I should note that this fall we will have an FDA decision of the approval of  denosumab (tentative commercial  name Prolia), a human monoclonal antibody RANKL inhibitor (the RANKL system is linked to osteoclast formation, activity, and survival), proving advantages over bisphosphonates and with its own anti-tumor and anti-metastatic activity, and with no appreciable adverse effects at all. I have been following its progress closely and know that Amgen is proceeding rapidly with commercialization, anticipating a positive judgment, so I am hoping it will be on the market right after the FDA decision date which currently stands at October 19, 2009.  The available evidence is indeed suggestive of several advantages over bisphosphonates, including:

 

  • minimal incidence of ONJ (osteonecrosis of the jaw),
  • lack of being incorporated into the bone mineral matrix and hence lack of long-term dwelling of the drug,
  • the degree to which denosumab suppresses bone turnover and reduces skeletal-related events (SREs) is non-inferior to intravenous bisphosphonates (like Zometa) and other bisphosphonates,
  • no serious toxicity or adverse events.

 

It's been compared head-to-head with Fosamax, the results showing that significantly greater increases in BMD were observed with denosumab treatment at all measured skeletal sites as well as significantly greater reduction of bone turnover markers compared with alendronate Fosamax) therapy. In addition, among patients with elevated bone markers representing excessive bone resorption (urinary NTX) despite ongoing intravenous bisphosphonate therapy (as with Zometa), denosumab normalized levels more frequently than bisphosphonate continuation. And  in a recent phase II study of patients with bone metastases showed that, denosumab was significantly more likely to suppress urinary NTX than pamidronate (Aredia). As  NTX levels are associated  with metastatic disease, this suggests benefit of antitumor / antimetastatic activity, and in preclinical models denosumab prevented bone metastasis and delayed progression of established metastases in breast (and prostate) cancer.

 


Constantine Kaniklidis

Breast Cancer Watch

edge@evidencewatch.com

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